Prophylactic Administration of Fibrinogen Concentrate in Perioperative Period of Total Hip Arthroplasty: a Randomized Clinical Trial Study

  • Atabak Najafi Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Reza Shariat Moharari Department of Anaesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Amir Ali Orandi Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Farhad Etezadi Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Mehdi Sanatkar Department of Anaesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Mohammad Reza Khajavi Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Arezoo Ahmadi Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Pejman Pourfakhr Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Farsad Imani Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Mojtaba Mojtahedzadeh Department of Pharmacotherapy and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Amir Hossein Orandi Mail Department of Anesthesiology and Critical Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Fibrinogen, Bleeding, Coagulation, Total hip arthroplasty

Abstract

According to limitations in blood product resources and to prevent unnecessary transfusions and afterwards complications in perioperative period of total hip arthroplasty, authors administered fibrinogen concentrate in a pilot randomized clinical trial to evaluate bleeding and need to blood transfusion in preoperative period. Thirty patients (3-75 years old) with ASA physical status class I or II and candidate for total hip arthroplasty consequently enrolled in this study and randomly assigned into two groups: taking fibrinogen concentrate and control. Two groups were similar in serum concentration of fibrinogen, hemoglobin, and platelet preoperatively. After induction of general anesthesia 30 mg/kg fibrinogen concentrate was administered in the fibrinogen group. Blood loss, need to blood transfusion and probable complications were compared between two groups. The mean operation time was 3.3 ± 0.8 hours in the fibrinogen group and 2.8 ± 0.6 hours in the placebo group, and this difference was statistically significant (P=0.04). There was a significant correlation between operation time and blood loss during surgery (P=0.002). The mean transfused blood products in the fibrinogen and control group was 0.8 ± 1.01 units and 1.06 ± 1.2 units respectively (P=0.53). The mean of perioperative blood loss was 976 ± 553 ml in the fibrinogen group and 1100 ± 350 ml in the control group, but this difference was not significant between two groups. By adjusting time factor for two groups, we identified that the patients in fibrinogen group had lower perioperative bleeding after adjusting time factor for two groups (P=0.046). None of the patients had complications related to fibrinogen concentrate administration. The prophylactic administration of fibrinogen concentrate was safe and effective in reducing bleeding in the perioperative period of total hip arthroplasty.

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How to Cite
1.
Najafi A, Shariat Moharari R, Orandi AA, Etezadi F, Sanatkar M, Khajavi MR, Ahmadi A, Pourfakhr P, Imani F, Mojtahedzadeh M, Orandi AH. Prophylactic Administration of Fibrinogen Concentrate in Perioperative Period of Total Hip Arthroplasty: a Randomized Clinical Trial Study. Acta Med Iran. 52(11):804-810.
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